When Arthritis Meets Cavovarus: A Unique Case of Bilateral Foot Deformity Managed with Fusion and Tendon Balancing in a Non-Charcot 60 year old Patient
Vol 06; Issue 1 | January 2025 | page: 43-47 | Shakti Swaroop, Nabin Kumar Sahu, Akilesh Panigrahy
DOI: https://doi.org/10.13107/ojot.2025.v06.i01.80
Received 26/03/2024; Reviewed 22/04/2024; Accepted 29/09/2024; Published 10/01/2025
Authors: Shakti Swaroop [1], Nabin Kumar Sahu [1], Akilesh Panigrahy [1]
[1] Department of Orthopaedic, IMS and SUM Hospital, SOA Deemed to be University, Bhubaneswar, Odisha, India.
Address of Correspondence
Akilesh Panigrahy,
Department of Orthopaedic, IMS and SUM Hospital, SOA Deemed to be University, Bhubaneswar, Odisha, India.
Email: drakleshpanigrahy@gmail.com
Abstract
Background: Cavovarus foot deformity in older adults can lead to progressive pain, instability, and secondary arthritis, particularly in the subtalar and talonavicular joints. The optimal surgical strategy for advanced arthritic cavovarus with significant structural deformity remains challenging.
Case Presentation: A 60-year-old male presented with bilateral cavovarus deformity (left > right), chronic hindfoot pain, instability, and functional limitation. Radiographs and clinical assessment confirmed rigid varus alignment and arthritic changes in the subtalar and talonavicular joints. Non operative management had failed.
Methods: We performed a staged reconstructive surgery on the more symptomatic left foot, consisting of subtalar joint arthrodesis to address painful arthritis and hindfoot malalignment, peroneus longus-to-brevis tenodesis to correct muscle imbalance and lateral instability, and a first metatarsal dorsal wedge osteotomy with Herbert screw fixation to correct forefoot varus and optimize overall foot posture.
Results: At 12 months follow-up, the patient reported significant reduction in pain, improved stability and gait, and radiographs demonstrated solid fusion with maintained alignment. Functional scores improved, and the patient resumed independent ambulation without assistive devices.
Conclusion: Combined subtalar arthrodesis, peroneal tendon balancing, and forefoot osteotomy provided stable alignment correction and durable pain relief in a rigid cavovarus foot with hindfoot arthritis
Keywords: Cavovarus , Hindfoot arthritis, Subtalar arthrodesis
References
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| How to Cite this Article: Swaroop S, Sahu NK, Panigrahy A. When Arthritis Meets Cavovarus: A Unique Case of Bilateral Foot Deformity Managed with Fusion and Tendon Balancing in a Non-Charcot 60 year old Patient. The Odisha Journal of Orthopaedics and Trauma. January 2025; 06;01:43-47. https://doi.org/10.13107/ojot.2025.v06.i01.80. |
